HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: RECFzvFp Permit Number:
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�ermiaication
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resi
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:'
Address: 4201 Rose Ln Fort Pierce, FL 34982 1
Legal Description: 34 35 40 E 110 FT OF W 279 FT
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Property Tax ID #. 2434-341-0002-000-1
Site Plan Name:
Project Name:
I �o /- 05�
10
APR 19 2018
Permitting Departme t
St. Lucie County, F11
135 FT OF N 160 FT OF E 15 AC OF SE 1/4 OF SW 1/4
Lot No.
Block No.
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
Reroof �[af goof 0�/ae, ch l5i-urct vSI na , -lay nteeG+ �•,•I�, I�ied
('��r i. -rlor( da i3u, (ding Code
CONSTRUCTION INFORMATION:
Additional work to be performed under tis permit-, check all apply:
�HVAC LJ Gas Tank Gas Piping _ Shutters T I Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 3 (2, S . Ft. of First Floor:
Cost of Construction: $ 14,957 — Utilities: U Sewer Septic Building Height: %a
OWNER/LESSEE: : .
CONTRACTOR:
Name Sharon Price
Name: William Brandon Edwards `—
Address: 4201 Rose Ln
Company: Storm Team Construction, Inc
Address: 4050 US Hwy 1
City: Fort Pierce State: FL'
Zip Code: 34982 Fax:
City: Jupiter State: FL
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Phone No. btv 1- a ,y 3 R
Zip Code: 33477 Fax:
Phone No. (561) 512-5891
E-Mail:
Fill in fee simple Title Holder on next page ( if different
"the
E-Mail: FLProduction@stormteamusa.com
from Owner listed above)
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State or County License: CCC1331451
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SU:PPLEIVIENTAL`�CONSTR. Cfl'O�N,LIEN,LAIN INFORMATIO'iV
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DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name: Sharon Price
Name: William Brandon Edwards
Address: 4201 Rose Ln Fort Pierce, FL 34982
Address: 4201 Rose Ln
City: Fort Pierce State:
City: Jupiter
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address: 4050 US Hwy 1
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, Pdo hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recordine vour Notice of Co'mrnencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signatures Contractor/License Holder
STATE .OF FL OR D
ZfIAA.
STATE OF FL D
COUNTY OF I hA
COUNTY O &Ak-
The f q ing instru nt w s acknowiedg efore me
this // day of 20 by
The fgr�Qing in tru nt w s acknowledged before me
this%/'"'day of W P l 2019 by
-A Ild�ay,42 S
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Name of pets n making statement
Personally Known OR Produced Identification
Name of person making statement
Personally Known a OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
v
e,4' I! '1G'U••, CHRISTA-LYtd SALMONSON
66(�,e� ISTA•LYN SALMONSON
(Signature of Notary blic- fat El'rit YjCOM
XPIRES; March 10, 2020
( nature of Notary Puidd COMMISSION 9
V.6
ryEXPIRES; March 10, 2020
hru Notary PubOc lJnde
No ti••'
ten 'B0Notary Public UnderwCommission
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mission No. /
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17